Indonesia to launch world’s largest health insurance system

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JKNIndonesia is planning to launch the world’s largest single-payer health care insurance programme between now and 2019. Under the new system, the government is committed to providing universal health care to its 247 million citizens, though employers and wealthier citizens are obliged to pay their own premiums, the Christian Science Monitor reported.

The programme was mandated by a law passed in 2004. But opposition from industry had stood in the way until now, since the law will require employers to pay premiums. The government also dragged its feet on implementation and was successfully sued in 2010 by a worker’s rights group for failing to follow the law.

Indonesia extended free health insurance to 48 per cent of its population on January 1. By the time the system is fully implemented in 2019 it will cover the whole country at an estimated cost of $15 billion a year – about $60 per Indonesian citizen and 15 per cent of the central government’s budget.

The insurance programme, known as Jaminan Kesehatan Nasional (JKN), differs from the US approach in one important way: choice. JKN doesn’t have any. Organisers here are betting its stripped-down, no frills policies will satisfy popular demand.

There are concerns about the cost of the program: Indonesia’s government will pay $2 per person per month to provide medically necessary treatment for the poor. Wealthier citizens are obliged to pay 5 percent of their monthly income into the programme and can opt to increase their coverage with private insurance.

But there is disagreement over how many people will qualify for 100 per cent government coverage and how many are wealthy enough to pay into the programme. An income threshold has not been announced. Just over one third of people are expected to qualify for the full subsidy.

To keep down costs and extend care, the government is looking to advances in information technology. Remote health clinics lacking a doctor can request online consultations.

Government officials also claim that their purchasing power will drive down the costs of medicines, though critics point to systemic corruption in government contracting.

The JKN rollout has not gone smoothly. Confusion regarding who needs to register, how doctors get compensated, and what medicines are available is rife. Not everyone needs to register: Those with preexisting government-issued insurance for the poor are automatically enrolled.

Indonesia also needs more medical professionals. Compared to neighbouring Malaysia, it has only a fifth of doctors per capita. But by creating a single-payer system for 247 million people, it has the potential to improve care and deliver inexpensive medicines.

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Reading Time: 2 minutes

Indonesia is planning to launch the world’s largest single-payer health care insurance programme between now and 2019. Under the new system, the government is committed to providing universal health care to its 247 million citizens, though employers and wealthier citizens are obliged to pay their own premiums, the Christian Science Monitor reported.

Reading Time: 2 minutes

JKNIndonesia is planning to launch the world’s largest single-payer health care insurance programme between now and 2019. Under the new system, the government is committed to providing universal health care to its 247 million citizens, though employers and wealthier citizens are obliged to pay their own premiums, the Christian Science Monitor reported.

The programme was mandated by a law passed in 2004. But opposition from industry had stood in the way until now, since the law will require employers to pay premiums. The government also dragged its feet on implementation and was successfully sued in 2010 by a worker’s rights group for failing to follow the law.

Indonesia extended free health insurance to 48 per cent of its population on January 1. By the time the system is fully implemented in 2019 it will cover the whole country at an estimated cost of $15 billion a year – about $60 per Indonesian citizen and 15 per cent of the central government’s budget.

The insurance programme, known as Jaminan Kesehatan Nasional (JKN), differs from the US approach in one important way: choice. JKN doesn’t have any. Organisers here are betting its stripped-down, no frills policies will satisfy popular demand.

There are concerns about the cost of the program: Indonesia’s government will pay $2 per person per month to provide medically necessary treatment for the poor. Wealthier citizens are obliged to pay 5 percent of their monthly income into the programme and can opt to increase their coverage with private insurance.

But there is disagreement over how many people will qualify for 100 per cent government coverage and how many are wealthy enough to pay into the programme. An income threshold has not been announced. Just over one third of people are expected to qualify for the full subsidy.

To keep down costs and extend care, the government is looking to advances in information technology. Remote health clinics lacking a doctor can request online consultations.

Government officials also claim that their purchasing power will drive down the costs of medicines, though critics point to systemic corruption in government contracting.

The JKN rollout has not gone smoothly. Confusion regarding who needs to register, how doctors get compensated, and what medicines are available is rife. Not everyone needs to register: Those with preexisting government-issued insurance for the poor are automatically enrolled.

Indonesia also needs more medical professionals. Compared to neighbouring Malaysia, it has only a fifth of doctors per capita. But by creating a single-payer system for 247 million people, it has the potential to improve care and deliver inexpensive medicines.

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